New Client application

Complete the following form to start with Brand Solicitors.

Welcome to Brand Barristers & Solicitors.

We invite you to complete the following form, which will allow us to streamline the process of establishing a file prior to your Obligation-free Meeting.

Kelly Prentice
Manager, Client Services

New client application form

Full Legal Name

Date of Birth

Address

Contact Number

Were you referred to BBS by anyone in particular?

Date of Accident

Details of your accident

Injuries Sustained

The name of your employer

Your occupation

Have you had any contact with any insurers? If so, which company?

Insurance Claim Number

Has that insurer accepted liability?

Yes No

Treating GP

Treating specialists

Level 3, 24 Outram Street, West Perth | Call +61 (08) 6260 0076

Level 3, 24 Outram Street, West Perth

Call +61 (08) 6260 0076

New Client application

Kelly Prentice
Manager, Client Services

New client application form

New Client application

Kelly Prentice Manager, Client Services

New client application form

Kelly Prentice
Manager, Client Services